Pulled Groin Muscle

A groin pull is an injury to the muscles of the inner thigh, also known as a groin muscle strain. The groin muscles, called the adductor muscle group, are made up of six muscles that run from the inner pelvis to the inner part of the femur (thigh bone).

These muscles pull the legs together and move your hip in other ways. The adductor muscles are especially important to athletes like sprinters, swimmers, soccer players, and football players.

Most groin pulls are relatively minor and have simply pulled a muscle beyond its normal range of motion, causing incidental tears. On rare occasions, severe strains can tear the muscle in two.

This article describes the symptoms of pulled groin muscle as well as the diagnosis, treatment, and recovery times. It also outlines some simple stretches that can help prevent groin injury.

Groin Pull Symptoms

A groin pull can be quite painful, interfering with your ability to walk, navigate stairs, or even drive a car. In addition to pain, there may other symptoms around the injured groin, including:

• Redness
• Swelling
• Bruising
• Popping sound or a snapping sensation at the time of the injury

Groin pulls are sometimes accompanied by a stress fracture of the pubis (the forward-facing pelvic bones).

Groin pulls are graded by their severity and how much they impact mobility:

• Grade 1: Mild discomfort but usually not enough to limit activity
• Grade 2: Moderate discomfort with swelling or bruising that limits your ability to run or jump
• Grade 3: Severe injury with significant swelling and bruising that can cause pain while walking along with muscle spasms

Severe groin pulls should be seen by a healthcare provider because the muscle may have ruptured or be close to rupturing. In such cases, you would need surgery to reattach the torn ends of the muscle.

Causes

Groin pulls are often experienced by athletes who play ice hockey and soccer because they have to rapidly change directions, often with their legs in a splayed position. This places excessive strain on the adductor muscles. The same may occur with people who play basketball, football, or rugby.

The risk of a groin muscle pull is greater in athletes who:

• Have weaker hip abductor muscles (the muscles pull the legs apart)
• Are not in peak physical condition
• Have had a previous groin or hip injury

Groin pulls can also occur in non-athletes due to falls or engaging in extreme activities without the proper conditioning.

Diagnosis

A pulled groin muscle is usually self-apparent. Most athletes know what the injury is the moment it occurs. Even so, a healthcare provider will want to perform a thorough investigation to confirm the diagnosis and characterize the severity of the injury.

This typically involves:

• A review of your medical history: This includes any previous injuries you've had and specifics about where and when your symptoms started.
• Physical examination: This would involve palpating (lightly touching and pressing) the groin and manipulating the leg to get a better sense of where and how extensive the injury is.
• Imaging studies: Typically, an ultrasound or X-ray will be ordered. If a muscle rupture or fracture is suspected, a magnetic resonance imaging (MRI) scan may be ordered as it is better able to visualize soft tissue injuries and stress fractures.

Differential Diagnosis

While a groin pull may seem obvious, there are certain conditions that can mimic it and require different treatments. These include:

• Sports hernia: This is a type of inguinal hernia that occurs during sport. It causes a portion of the intestine to spontaneously pop through a weakened muscle in the groin.
• Hip labral tear: This is a tear in the ring of cartilage, called the labrum, that encircles the outside rim of the hip joint socket
• Osteoarthritis of the hip: This is the "wear-and-tear" form of arthritis that can manifest with pain in the groin.
• Osteitis pubis:This is the inflammation of the pubic bone typically caused by the overuse of the hip and leg muscles.
• Referred groin pain: This is nerve pain that originates in the lumbar spine, most often due to a pinched nerve, but registers in the groin.

Treatment

The treatment of a pulled groin muscle is typically conservative and includes rest, ice application, and gentle stretching when appropriate. If the pain is significant, you may be advised to use crutches to reduce pain and prevent further injury.

Over-the-counter pain medications like Tylenol (acetaminophen) or Advil (ibuprofen) are commonly prescribed. If there is severe pain from a grade 3 injury, a prescription opioid drug like fentanyl or Oxycontin (oxycodone) may be used for a short period to help minimize pain.

Surgery is not usually necessary.

Recovery times can vary based on the severity of the injury and your physical condtion before the injury. Physical therapy is almost invariably a part of the treatment plan.

Stretches to Prevent Groin Muscle Pulls

Proper conditioning is needed to prevent groin strain in athletes. The exercises help strengthen the adductor muscles, stabilize the pelvis, and strengthen the core muscles of the mid-torso (including the abdominal, oblique, and multifidus back muscles).

If you have a groin strain, a stretching program will also help by keeping the muscles flexible and less prone to tears.

When done correctly, stretches should cause a gentle pulling sensation but never pain. If there is pain, you are overdoing it and need to ease back.

There are four exercises that are especially good at preventing groin muscle pulls:

Squatting Adductor Stretch

To do the squatting adductor stretch:

1. Squat to the ground with one leg in front of your body.
2. Allow your opposite leg to extend behind you.​
3. Stretch your legs apart by gently pushing over your front knee.
4. Hold for 10 to 20 seconds, gradually increasing the time as your flexibility builds.

Standing Adductor Stretch

This adductor stretch is done while standing, as follows:

1. Stretch one leg out to the side, keeping your other leg under your torso.
2. Bend the knee underneath your torso to lower yourself and stretch the muscles of the inner thigh of the opposite leg.
3. Your outstretched leg should have a straight knee, and you should feel the stretch on the inner thigh.
4. Hold for 10 to 20 seconds, gradually increasing the time as your flexibility builds.

Butterfly Stretch

The butterfly stretch is done in a sitting position, as follows:

1. Sit with your feet together and knees bent.
2. Grasp your feet with your hands.
3. Stretch your knees down toward the ground.
4. Do not bounce. Feel the stretch along your inner thigh.
5. Hold for 10 to 20 seconds, gradually increasing the time as your flexibility builds.

Cross-Leg Stretch

The cross-leg stretch is also done while sitting, as follows:

1. While sitting, cross one leg over the other.
2. Press the knee of the crossed leg across the body to open up the hip. The stretch will emphasize the muscles of the inner thigh and front of the thigh.
3. Hold for 10 to 20 seconds, gradually increasing the time as your flexibility builds.

Summary

A groin pull is an injury to an inner thigh muscle. Most of the time, these strains involve small tears to the muscles and can usually be treated with rest, gentle stretching, and over-the-counter pain medications.

Some groin pulls can be severe and cause a muscle to completely rupture. These tears have to be repaired with surgery. Recovery times can be extensive, lasting up to 12 weeks or more.

To prevent groin pulls, stretch regularly. You may also want to include exercises that strengthen your adductor, pelvic, and core muscles.

A Word From Verywell

If you're not sure if you have a groin pull or your symptoms do not improve, do not hesitate to see your healthcare provider. Other conditions can be confused with a groin pull, and they may need different treatments.

If your primary care provider cannot pinpoint the cause, ask for a referral to a sports medicine specialist or an orthopedist who specializes in diseases and disorders of the skeleton and muscles.